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News and Important InformationWhat is Medical Necessity and How Does Documentation Support It? The Impact of Medical Necessity on High Level E/M Services Newsletters and ArticlesCPT Assistant ArticlesCPT® Assistant Search AHA Coding Clinic ArticlesAHA Coding Clinic® Articles Search Decision Health ArticlesDecision Health Article Search Just Coding NewsletterJustCoding® Newsletter Search BC Advantage MagazineBC Advantage Magazine & CEUs Medicare Compliance NewsletterMedicare Quarterly Provider Compliance Newsletter Find-a-Code ArticlesMedical Coding and Billing Articles Find-A-Code NewsletterFind-A-Code Focus Newsletter Newletters ArticlesClick the article title to view a summary and link to the full article. Let's Talk High Risk E/M ServicesApril 23rd, 2019 | Published April 23rd, 2019 Have you ever assigned a high-complexity E/M code (e.g., 99205, 99215, 99223, 99233, 99245, etc.) and wondered if it would stand up to further scrutiny? Well, let’s take a closer look at the requirements for reporting high-level E/M services.
Both the American Medical Association and Medicare-published E/M Guidelines agree that a ... What is Medical Necessity and How Does Documentation Support It?April 23rd, 2019 | Published April 23rd, 2019 We recently fielded the question, “What is medical necessity and how do I know if it's been met?"
The AMA defines medical necessity as:
It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ... The Impact of Medical Necessity on High Level E/M ServicesMarch 21st, 2019 | Published March 21st, 2019
I was recently asked the question, "Does 99233 require documentation of a past medical, family, and/or social history (PFSH)?"
The quick answer is, "it depends."
Code 99233 has the following minimal component requirement:
Subsequent inpatient E/M encounters can meet the code level requirement either by component scoring & medical necessity or time & medical necessity. ... Understanding NCCI EditsMarch 1st, 2019 | Published March 1st, 2019 Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for ... Proposed Rule: Expanded Telemedicine Benefits for Medicare Advantage BeneficiariesFebruary 14th, 2019 | Published February 14th, 2019 Telemedicine continues its rise, with new technologies allowing for better communication and access to more aspects of healthcare than ever before. Each year Medicare has made strides, albeit small strides, in their telemedicine coverage while commercial payers continue to make great strides, constantly improving and expanding telemedicine service offerings to ... Truncated ICD-10-CM Official Guidelines for Coding and ReportingJanuary 22nd, 2019 | Published January 22nd, 2019
Adherence to ICD-10-CM official guideline's are required under HIPAA and adopted for all healthcare settings. We have made it easy to access guidelines and made them available on the code information page, either on the page you are viewing or view more information by selecting the ICD-10-CM Chapter Section/Guidelines and ... WHO Said ICD-11 is Coming SoonJune 26th, 2018 | Published June 26th, 2018 Sooner or later ICD-11 will be released, and it sounds like it will be sooner than later. WHO released the news on June 18, 2018. The World Health Organization stated “ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come ... Newletters TipsAccess to this feature is available in the following products:
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